RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01580
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070725

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Infantryman, medically separated for “mild to moderate hearing loss bilaterally” with a disability rating of 0%.   

CI CONTENTION:  “If the rating should be changed the medical benefit would greatly help me in the future.”  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the Medical Evaluation Board (MEB), but determined by the PEB to be not unfitting or non-compensable.  Any conditions outside the panel’s defined scope of review, and any contention not requested in this application, may remain eligible for future consideration by the Board for Correction of Military Records.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for the unfitting medical condition(s) at the time of separation.  The panel has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions; that role and authority is granted by Congress to the Department of Veterans Affairs, which operates under a different set of laws.  The panel gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20070702	VARD - 20080319	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Mild to Moderate Hearing Loss Bilaterally	6100	0%	Bilateral Hearing Loss	6100	0%	20080228	
			Tinnitus	6260	10%	20080228	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Mild to Moderate Hearing Loss Bilaterally.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s bilateral hearing loss began prior to entering service but became acutely worse in December 2006 while attending a 3 day training exercise, during which he did not wear hearing protection.  During the 30 April 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported hearing loss with tinnitus (ringing or buzzing in the ears) in both ears.  Physical examination showed normal ears generally with normal ear drums.  The screening pure tone audiogram showed thresholds in the right ear of 5 dB at 1000 Hz, 5 dB at 2000, 65 dB at 3000, and 60 dB at 4000.  The left ear showed 10 dB at 1000, 25 dB at 2000, 60 dB at 3000, and 55 dB at 4000.  Speech discrimination testing was not performed.  

The 1 June 2007 MEB NARSUM examination, 2 months prior to separation, noted complaints of tinnitus in both ears since December 2006.  He also felt he may have damaged his hearing when he was engaged in combat without warning and without hearing protection.  He did not feel he was having significant hearing problems at the time of the NARSUM; the tinnitus was the most bothersome complaint to him.  Physical examination did not address the ears.  The examiner referenced a 16 January 2007 comprehensive audiology evaluation, which showed “moderate to severe ‘noise notch’ at 3 KHz and 4 KHz; otherwise hearing [was] essentially [within normal limits].  Good word recognition in QUIET.  Poor SPRINT (speech recognition in noise test) scores…”

At the 28 February 2008 VA Compensation and Pension (C&P) examination, 7 months after separation, the CI reported decreased hearing since 2006 and constant tinnitus bilaterally.  Pure tone audiogram for the right ear showed thresholds of 5 dB at 1000 Hz, 15 dB at 2000 Hz, 60 dB at 3000 Hz, and 55 dB at 4000 Hz for an average of 33.75 dB.  The left ear demonstrated 10 dB at 1000 Hz, 25 dB at 2000 Hz, 60 dB at 3000 Hz, and 50 dB at 4000 Hz resulting in an average of 36.25 dB.  The Maryland CNC word list recognition score for each ear was 100%.  

The VASRD §4.85 and §4.86 rating schedules for hearing impairment are completely objective and derived from audiometric testing.  They are based on average puretone threshold across the hearing ranges from 1000 to 4000 Hz, and accommodate for measured speech discrimination when available.  The charted results of the audiometric evidence in this case yield unequivocal 0% ratings for both sets of data.  Results of the audiometric evaluations are displayed in the chart below:

HEARING	EXAM	MEB  ~5 Mo. Pre Sep	VA C&P ~7 Mo. After Sep	
LEFT EAR	Average Hearing Loss	37.5 dB	  36.25 dB	
	Speech Discrimination	N/A	100%	
	Table VI / VIa	I	I	
RIGHT EAR	Average Hearing  Loss	33.75 dB	33.75 dB	
	Speech Discrimination 	N/A	100%	
	Table VI / VIa	I	I	
§4.85 RATING	Table VII	0%	0%	
(Average hearing loss is the sum of pure tone thresholds at 1000, 2000, 3000, and 4000 Hz divided by four)

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral hearing loss condition 0%, coded 6100 (hearing loss).  The VA also rated the bilateral hearing loss condition 0%, coded 6100, based on the C&P examination, citing objective testing.  The panel notes that the MEB forwarded bilateral tinnitus to the PEB for adjudication, however, by not adjudicating tinnitus, the PEB de-facto declared the condition not-unfitting.  Since the CI did not specifically contend the tinnitus condition, it is beyond the panel’s scope of review.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the bilateral hearing loss.  

BOARD FINDINGS:  In the matter of the bilateral hearing loss and IAW VASRD §4.85, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170224, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180005246, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,					      
Enclosure